一例难治性癫痫持续状态患者行血浆置换对高剂量苯巴比妥血药浓度影响的病例分析

Effect of One Patient with Refractory Status Epileptics Undergoing Therapeutic Plasma Exchange on Plasma Concentration of High-dose Phenobarbital Regimen

目的探讨血浆置换治疗难治性癫痫持续状态对高剂量苯巴比妥血药浓度的影响。方法临床药师参与一例难治性癫痫持续状态患者的诊治过程,给予该患者负荷剂量苯巴比妥并行五次血浆置换,并采用气相色谱-质谱联用仪在置换前后分别检测血药浓度。结果患者行第2、3、4次置换前后,苯巴比妥的血浆浓度分别是131/139μg·mL^-1、98.3/102.2μg·mL^-1、95.6/96.3μg·mL^-1。结论血浆置换并未显著降低苯巴比妥血浆浓度,因此,置换后无须增加苯巴比妥剂量。

OBJECTIVE To explore the influence of therapeutic plasma exchange on plasma concentration of high-dose Phenobarbital(PB).METHODS A clinical pharmacist analyzed the treatment for one patient with refractory status epileptics.The patient was treated with load dose injection of PB as well as therapeutic plasma exchanges with five times.The plasma concentrations of PB were measured by gas chromatography-mass spectrometer before and after therapeutic plasma exchange.RESULTS The plasma concentrations of PB were 131/139μg·mL^-1,98./102.2μg·mL^-1,95.6/96.3μg·mL^-1 before and after the second,third,fourth therapeutic plasma exchange,respectively.CONCLUSION Therapeutic plasma exchange may not significantly affect the plasma concentration of PB.There was no need to increase PB dosage before and after therapeutic plasma exchange.